Term
| what are two other names for hospital acquired infection |
|
Definition
nosocomal infection
iatrogenic infection |
|
|
Term
| what are the qualifications of HAI |
|
Definition
| acquired in hospital >48h after admission |
|
|
Term
| who is at high risk for HAI |
|
Definition
| IV, port, cath, intubation, ICU, post op, immune compormised |
|
|
Term
|
Definition
| hand washing, infection control programs, prudent antibiotic use |
|
|
Term
|
Definition
| self, others, air, food, dust, IV, cath, washbowl, bedpan, endoscope, ventilator, water, disinfectants |
|
|
Term
| #1 hospital acquired infection in adults |
|
Definition
|
|
Term
| 3 top causes of UTI HAI and their gram stain |
|
Definition
1. E. coli GNR
2. Candidia KOH
3. P. aeruginosa GNR |
|
|
Term
| #2 hospital acquired infection in adults |
|
Definition
|
|
Term
| 2 causes of surgical wound infection HAI and their gram stain |
|
Definition
1. S. aureus GPC
2. P. aeruginosa GNR |
|
|
Term
| what is the most likley introduction method of microbes in a HAI LRI |
|
Definition
|
|
Term
| 3 top causes of LRI HAI and their gram stain |
|
Definition
1. S. ayreys GPC
2. P. aerguinosa GNR
3. A. baymanni GNR |
|
|
Term
| what is the most likley introduction method of microbes in a HAI bacteremia |
|
Definition
|
|
Term
| what is the #1 HAI in infants and kids |
|
Definition
|
|
Term
| 3 top causes of HAI bacteremia and their gram stain |
|
Definition
1. S. aureus GPC
2. enterococci GNR |
|
|
Term
|
Definition
fever
purulent sputum
leukocytosis
decline in O2 |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| S. aureus: catalase, coagulase, hemolysis? |
|
Definition
B hemolytic
catalase positive
coagulase negative |
|
|
Term
| which HA pneumo are difficult to treat, why |
|
Definition
S. aureus - resistance due to mecA gene mutating PBP2a
P. aeruginosa - antibiotic resistance : two drug bug
A. baumannii - B lactaminase, alters porins, efflux pumps |
|
|
Term
| transmission of S. aureus |
|
Definition
|
|
Term
| P. aeruginosa: oxidaze, lactose? |
|
Definition
oxidase positive
non-lactose fermentind |
|
|
Term
| P. aeruginosa: color, smell |
|
Definition
|
|
Term
| P. aeruginosa: who does it invade |
|
Definition
| weak invader: compormised |
|
|
Term
| P. aerguinosa: where does it live and transfer on |
|
Definition
| soil, water, plants, animals, intestinal flora, skin, medical devices, hands |
|
|
Term
| P. aerguinosa: virulence factors (2) |
|
Definition
endotoxin A: similar to diptheria toxin
antiphagocytic and adhesive capsule |
|
|
Term
| P. aerguinosa: 7 clinical signs / conditions |
|
Definition
Burns
endocarditis
pneumonia
sepsis
external malignant otitis media
UTI
diabetic osteomyelitis |
|
|
Term
| Acinetobacter baumannii: oxidase, catalase? |
|
Definition
catalse positive
oxidase negative |
|
|
Term
| Acinetobacter baumannii: location/transmission |
|
Definition
ubiquitous: present everywhere
soil, water, skin, secretions, medical devices, hands |
|
|
Term
| Acinetobacter baumannii: who does it infect |
|
Definition
| weak invader: compormised |
|
|
Term
| Acinetobacter baumannii: 4 clinical signs / conditions |
|
Definition
Burns
E
Pneumonia
Sepsis
E
UTI
D
O |
|
|
Term
| Clostridium difficile: gram stain, metabolism, reproduction |
|
Definition
anaerobic
GPR
spore forming |
|
|
Term
| C. difficule: clinical condition, its cause, its tx |
|
Definition
pseudomembranous colitis
cause: clindamycin (metronidazole, vancomycin)
tx: metronidazole, vancomycin |
|
|
Term
| cause of FUO Post Op 1-2 days |
|
Definition
| wind: atelectasis, pneumonia |
|
|
Term
| cause of FUO Post Op 3 days |
|
Definition
|
|
Term
| cause of FUO Post Op 5 days |
|
Definition
| walk: deep vein thrombosis |
|
|
Term
| cause of FUO Post Op 7 days |
|
Definition
| wound: surgical wound infection |
|
|
Term
| cause of FUO Post Op 1-10 days |
|
Definition
| weird: drug induced fever |
|
|
Term
| cause of FUO Post Op 10 days |
|
Definition
|
|
Term
| what are the 7 steps of sepsis |
|
Definition
infection
bacteremia fungemia
systemic inflammatory response syndrome
sepsis
severe sepsis
septic shock
multiple organ dysfunction syndrome |
|
|
Term
|
Definition
| inflammatory response to microbe due to invasion of a sterile site |
|
|
Term
| define bacteremia/fungemia, what are the potential causes |
|
Definition
presence of microbe in blood
causes: bacteria, fungi, virus, parasite
does not mean septicemia |
|
|
Term
| causes of systemic inflammatoy response syndrome |
|
Definition
| infection, organ failure, trauma, burns, shock |
|
|
Term
|
Definition
temp >38 or <35C
HT >90
RR >20
pCO@ <32
WBC <1200, <4000, >10% band cells |
|
|
Term
| qualifications for sepsis |
|
Definition
SIRS with at least one organ dysfunction, hypoperfusion, HYPOTENSION
evidence of or strong suspicion of infection
ex symptoms: LACTIC ACIDOSIS
oliguria
altered mental status
mottled skin
DIC
ARDS
CHF |
|
|
Term
| qualifications for septic shock |
|
Definition
| sepsis with hypotension despite fluid recussitation, requires vasopressors |
|
|
Term
| what is a determinant of outcome of septic shock |
|
Definition
| >3 organs failing means 50% chance of living |
|
|
Term
| qualifications for multiple organ dysfunction syndrome |
|
Definition
| progressive distand organ failure |
|
|
Term
| causes of multiple organ dysfunction syndrome |
|
Definition
| infection, burns, shock, trauma, other |
|
|
Term
| what causes 50% of septic shock |
|
Definition
gram positive organisms
S. aureus: LRT
S. pneumo: pneumo
enterococcus: UTI |
|
|
Term
| what causes 30% of septic shock |
|
Definition
Gram negative bacteria
E. coli |
|
|
Term
| top three sources of infection leading to sepsis |
|
Definition
lung 40%
abdomen 20%
urine 15% |
|
|
Term
| manifestation of end organ dysfunction: carduac |
|
Definition
| tachycardia, decreased contraction |
|
|
Term
| what is the second most common end organ dysfunction at the time of sepsis DX |
|
Definition
|
|
Term
| manifestation of end organ dysfunction: pulmonary |
|
Definition
| tachypena, respiratory alkalosis/acidosis, ARDS |
|
|
Term
| what is the most common end organ dysfunction at the time of sepsis DX |
|
Definition
|
|
Term
| manifestation of end organ dysfunction: vascular |
|
Definition
| decreased tone, increased permeability, shock |
|
|
Term
| manifestation of end organ dysfunction: hematologic |
|
Definition
| DIC, thrombocytopenia, prolonged PTT/PT |
|
|
Term
| what are the limits on PTT/PT |
|
Definition
|
|
Term
| manifestation of end organ dysfunction: renal |
|
Definition
| pre-renal azotemia, acute failure, acute tubular necrosis, increased BUN/CR |
|
|
Term
| manifestation of end organ dysfunction: hepatic |
|
Definition
| increased transaminases, bilirubiin, jaundice |
|
|
Term
| manifestation of end organ dysfunction: CNS |
|
Definition
|
|
Term
| manifestation of end organ dysfunction: metabolic |
|
Definition
|
|
Term
| manifestation of end organ dysfunction: GI |
|
Definition
|
|
Term
| what on gram negatives cause septis |
|
Definition
LPS/endotoxins
bacterial flagellin
nucleic acids |
|
|
Term
| what on gram positives cause sepsis |
|
Definition
trichoic acid
peptidoglycan
superantigens (cause TSS)
bacterial flagellin
nucleic acids |
|
|
Term
| what microbes dont have peptidoglycan |
|
Definition
mycoplasma and ureaplasma
mostly chalmydia
even though all atypicals, NOT legionella |
|
|
Term
| what do viruses have that can cause septis |
|
Definition
|
|
Term
|
Definition
have PRR (pattern recognition receptors) that see pathogen associated molecules (PAMPS) on microbes
trigger release of proinflammatory metiators |
|
|
Term
|
Definition
pro inflammatory
release ROS and lipid mediators from PMN/mono/esino which cause vasodilation, permeability of capillaries, fever, hypotension, coagulation |
|
|
Term
| endothelial cells and macrophages causes release of these 4 things when stimulated by TNF/IL1 |
|
Definition
|
|
Term
|
Definition
vasodilation
increased pulmonary A pressure
decreased CO |
|
|
Term
|
Definition
| activate PAF which causes hypotension |
|
|
Term
|
Definition
| activate PGE2 which causes fever, pain,inflammation |
|
|
Term
|
Definition
| activate leukotrienes causing neutrophil chemotaxis |
|
|
Term
| define passive immunity, what are the benifits and down sides |
|
Definition
subject receives antibodies in form of Ig
immunity is not long term but good when immunity is needed rapidly |
|
|
Term
| what is an example of natural passive immunity |
|
Definition
mother to child
IgG through placenta
IgA through breast milk |
|
|
Term
| what is an example of artificial passive immunity |
|
Definition
| immunization with antibodies |
|
|
Term
|
Definition
| subject is exposed to infection and produces antibodies |
|
|
Term
| what is an example of natural active immunity |
|
Definition
|
|
Term
| what is an example of artificial active immunity |
|
Definition
| immunization with antigen administration |
|
|
Term
| why do we combine active and passive immunity for rabies |
|
Definition
when infected with rabies you give the antibodies to take care of initial antigen
the antibodies are short lived so they outlive the initial infectin so give the vaccine too so it picks up when the antibodies run out |
|
|
Term
|
Definition
basic reproductive number
average number of people directly infected by one infected person when they enter a susceptible popultation |
|
|
Term
|
Definition
duration of infection
infectiousness of the organism
number of susceptible people they come in contact with |
|
|
Term
| what is the overall percent of people who need to be vaccinated to protect the population from an epidemic |
|
Definition
|
|
Term
| what are the live attenuated vaccines |
|
Definition
rotavirus
influenza
MMR
varicella/yellow fever |
|
|
Term
| what vaccines are contraindicated in those with egg allergies |
|
Definition
|
|
Term
| what vaccines are contraindicated in those with neomycin allergies |
|
Definition
| MMR and inactivated salk polio |
|
|
Term
| what are the contraindications to live attenuated vaccines, why |
|
Definition
immune compormised, pregnancy
may revert to wild type and become virulent again |
|
|
Term
| what is a live attenuated vaccine made of, how does it work |
|
Definition
pathogen is active but has reduced virulence
they colonize, infect, and replicate within pt but do not cause disease
this generates the most robust immunological response without auctally getting the disease |
|
|
Term
| when is the DTap administered, why |
|
Definition
6wk to 6yo
it is a pediatric vaccine, if given to adult it works fine but they have already had it so their arm will swell and be very painful because the vaccine is a higher concentration |
|
|
Term
| when is the Tdap vaccine administered, why |
|
Definition
when an adult
it is less concentrated and kids who have not been vaccinated before will not respond to it |
|
|
Term
|
Definition
| if you have HAD varicella zoster. NOT if you just had the vaccine |
|
|
Term
| why are the rates of shingles increasing |
|
Definition
| kids are now vaccinated and are not exposing the active disease to their parents so they do not get a "booster" exposure and the immune system weigns allowing it to surface again |
|
|
Term
|
Definition
S. aureus
S. epidermitis
diptheroids
streo |
|
|
Term
|
Definition
S. epi
s. aureus
diptheroids
strep
pseudomonas
anaerobes
candidia |
|
|
Term
|
Definition
lactobacilli
strep
bacteroides |
|
|
Term
|
Definition
99%...
bacteroides, fusobacteroim, enterococcus fecalis
then...
E. coli, lactobacillus |
|
|
Term
|
Definition
lactobacillus
E. coli
GBS
diptheroids
candidia
trichomonas |
|
|
Term
|
Definition
S. epi
strep
GNR
diptheroids |
|
|
Term
|
Definition
|
|
Term
|
Definition
S. viridans
S. pyogenes
S. pneumo
neisseria
H. influenza
S. epi |
|
|
Term
|
Definition
bacteroides
actinomyces
fusobacterium
trichomonas
entaoemba gingivalis |
|
|
Term
|
Definition
|
|
Term
|
Definition
S. viridans
Strep
E. corrodenes
candidia |
|
|
Term
|
Definition
S. aureus
HIB
N gonorrhea
C trachomatus |
|
|
Term
|
Definition
S. pneumo
H. influenza
M. cararrhalis |
|
|
Term
|
Definition
S. pyogenes
H. ineluenza
B. pertussus |
|
|
Term
|
Definition
|
|
Term
| 8 causes of food poisoning |
|
Definition
camplobacter
E. coli
salmonella
shigella
C. difficile
becillus
aeromonas
listeria
Yersinia |
|
|
Term
|
Definition
E. coli
P. mirabilis
E. fecalis
S. saphrophiticus
P. aeruginosa |
|
|
Term
|
Definition
C. trachomatis
N. gonorrheae
T. pallidum
M. genitalium
U. urealyticum
H. ducreyi |
|
|
Term
|
Definition
S. aureus
S. pyogenes
P. aeruginosa |
|
|
Term
| 3 common pathogens otitis media |
|
Definition
S. pneumo
H. influenza
M. catarrhalis |
|
|
Term
| 5 common pathogens meningitis |
|
Definition
S. pneumo
N. meningitidis
H. influenza
GBS
listeria |
|
|
Term
| 4 common pathogens HA pneumo |
|
Definition
P. aeruginosa
NRSA
K. pneumo
actineobacteri |
|
|
Term
| 3 common pathogens CA pneumo |
|
Definition
S. pneumo
atypical bacteria
H. influenza |
|
|
Term
| 4 common pathogens for atypical pneumo |
|
Definition
mycoplasma, chalmydophila, legionalla
TB - not atypical, fungal, mentally grouped only |
|
|
Term
| explain how to distinguish the staphs |
|
Definition
all gram positive cocci
all catalase positive
S. aureus is coagulase positive
S. epi is novobiocin susceptible
S. saphrophiticus is novobiocin resistant |
|
|
Term
| explain how to distinguish the streps |
|
Definition
all gram positive cocci
all catalase negative
a hemolytic
- optochin sensitive S. pneumo
- optochin resistant S. viridans, S. mutans, S. sanguis
B hemolytic
-Bacitracin sensitive GAS (S. pyogenes)
-Bacitracin resistant GBS (S. aglactiae)
Y hemolysis
-6.5%NaCl positive E. fecalis
-6.5%NaCl negative S. gallolyticus (S. bovis)
- grows on Bile azide esculin agar |
|
|
Term
| explain how to distinguish the GPR |
|
Definition
acid fast positive: mycobacterium
acid fast negative
-spores: clostridium, bacillus
-none: corynebactrium, listeria |
|
|
Term
| explain how to distinguish the GP filamentous |
|
Definition
acid fast positive: nocatdia
acid gast negative: actinomyces |
|
|
Term
| what are the difficult to culture / atypical bacteria |
|
Definition
chalmydia/chalmydophlia
mycoplasma
ureaplasma
legionella |
|
|
Term
| explain how to distinguish the GNDC |
|
Definition
glucose fermenting negative: moraxella catarrhalis
glucose fermenting positive
- maltose ferment positive: N. meningitidis
- maltose ferment negative: N. gonorrhea |
|
|
Term
| what are the GN coccoid rods, how can one be distuinguished |
|
Definition
haemophius: needs X and V factors
pasturella
brucella
bordatella pertussus |
|
|
Term
| what are the GN comma rods |
|
Definition
camplobacter jejuni
vibro chlera |
|
|
Term
| explain how to distinguish the GNR |
|
Definition
lactose ferment positive: Klebsiella, E. coli, enterobacter
lactose fermentnegative
- oxidase negative: acinetobacter, proteus, salmonella, shigella
- oxidase positive: helicobacter
camplobacter, vibrio, PSEUDOMONAS |
|
|
Term
| what does moraxella cararrhalis ferment |
|
Definition
|
|
Term
| what diseases does moraxella cararrhalis cause |
|
Definition
|
|
Term
| what does N. lactamia ferment |
|
Definition
| glucose, maltose, LACTOSE |
|
|
Term
| what does N. meningitidis ferment |
|
Definition
|
|
Term
| what does N. gonorrhea ferment |
|
Definition
|
|
Term
| what does E. coli ferment |
|
Definition
|
|
Term
| what are the ways to identify P. aerguinosa |
|
Definition
non lactose fermenting
oxidase positive |
|
|
Term
| what are the ways to identify S. saphrophyticus |
|
Definition
Novobiocin resistant
catalase positive
coagulase negative
Non-mannitol fermenting |
|
|
Term
| what are the ways to identify S. epi |
|
Definition
novobiocin sensitive
catalase positive
coagulase negative |
|
|
Term
| how is syphilis identified |
|
Definition
|
|
Term
| what does herpes look like |
|
Definition
| cluster of painful blisters |
|
|
Term
| what does ducrei look like |
|
Definition
|
|
Term
| what does chalmydia L1-3 cause, what are the symptoms |
|
Definition
| lymphogranuloma venerium: nodes swell, erupt, form open sore |
|
|
Term
| what does chalmydia A-C cause |
|
Definition
|
|
Term
| what does chalmydia serotype D-K cause |
|
Definition
STI
PID
urethritis
ectopic pregnancy
neonatal conjunctivitis/pneumo |
|
|
Term
| how is chalmydia identified |
|
Definition
non-infectious reticular bodies in cells
(infectious elementary bodies are invisible) |
|
|
Term
| how is gonorrhea diagnosed |
|
Definition
GNDC intracellular - in male (lactobacillus in female is too similar)
nucleic acids in female |
|
|
Term
|
Definition
burning urination
cream colored purulent discharge |
|
|
Term
| why wouldnt an antibiotic work for an STD |
|
Definition
| they have a secondary infection |
|
|
Term
| what is a complication of gonorrhea |
|
Definition
|
|
Term
|
Definition
| sexual transmission, ping pong |
|
|
Term
| identification of trichomonas |
|
Definition
possible positive whiff test
frothy green/yellow discharge
strawberry cervic (punctuate microhemorrhages)
wet prep: swimming pears |
|
|
Term
| identification of gardenerella vaginalis |
|
Definition
high pH (bacterial imbalance)
fishy odor on whiff test
clue/glittr cells |
|
|
Term
| identification of candidia |
|
Definition
white thick cottage cheese discharge
hyphe on KOH |
|
|
Term
|
Definition
oral and vaginal thrush
diaper rash
between fingers
body folds - red |
|
|
Term
|
Definition
| tzank cells: multinucleated giant cells on wright gemisa stain |
|
|
Term
| cause of osteomyelitis in sickle cell, why |
|
Definition
| salmonella: capillary occlusion due to intravascular sickling may devitalize the gut and infarct allowing salmonella to escape into bone |
|
|
Term
| 4 causes newborn meningitis |
|
Definition
listeria
GBS
rubella
E. coli |
|
|
Term
| 5 causes adult meningitis |
|
Definition
S. pneumo
N. meningitis
H. influenza
GBS
listeria |
|
|
Term
|
Definition
|
|
Term
|
Definition
S. aureus/MRSA
acineobacter
P. aeruginosa |
|
|
Term
|
Definition
S. aureus/MRSA
acineobacter
P. aeruginosa |
|
|
Term
| HepB blood markers: vaccinated |
|
Definition
|
|
Term
| HepB blood markers: resolved |
|
Definition
+ anti-HBs
+ anti-HBc (IgG) |
|
|
Term
| HepB blood markers: chronic carrier (infectious and not) |
|
Definition
+ HBsAg
+/- HBeAg
+ anti-HBc (IgG) |
|
|
Term
| HepB blood markers: infected (acute resolving) |
|
Definition
+ HBsAg
+ anti-HBs
+ anti-HBc (IgM)
+ anti-HBc (IgG) |
|
|
Term
| HepB blood markers: acute (early) |
|
Definition
+ HBsAg
+ HBeAg
+ anti-HBc (IgM)
+ anti-HBc (IgG) |
|
|
